Schizophrenia by any other name…

Schizophrenia by any other name

…

24 November 2017

Richard: So, you do know that I have a mental illness?

Stephanie: Yes you’re schizophrenic, aren’t you?

This was a brief snippet of a conversation I had with a colleague whilst preparing for my radio show on Eastside Radio. It may not seem like much, but this question and answer captures one of the more subtle issues in dealing with illnesses like schizophrenia.

You see, Stephanie did not answer “Yes, you have schizophrenia, don’t you?” She used the phrase “you are schizophrenic”. And I believe an important issue is tied up in the relationship between these two phrases.

To say someone is schizophrenic is to say that their entire identity is subsumed by their illness. They are the illness. Everything else about their self– their job, their age, their gender, their religion – seems secondary. They have a life-long, defining, limiting mark upon their mind.

To say someone has schizophrenia contains a vital distinction. To have schizophrenia is to be a person afflicted by an illness; not an incarnation of the illness itself. It indicates that while illness is terribly serious and life-long, it does not capture everything about me. There are various elements to my identity, positive and negative, that exist independently of the illness.

In brief comparison, we would never say that someone is “cancerous” or someone is “demented”.

And this leads me to my second issue. The word “schizophrenia” itself.

Richard: So I wrote my PhD on the sociology of schizophrenia.
Rob: Oh, does that mean you had multiple opinions?

As we all know, the term schizophrenia is commonly misunderstood. People think it refers to multiple personalities, as my acquaintance did here; to people fundamentally disconnected from reality who will cause gratuitous and unpredictable violence. It is hard to quantify how much stigma comes with this term.

So, perhaps, we should change the term itself?

Perhaps we should rename it “cognitive integration disorder”, or “integration disorder”, as the Japanese have done?

And maybe such a name change would have some impact in de-stigmatising the term?

My gut feeling, however, is that the word “schizophrenia” will remain, as it has for at least a century, in the public consciousness. And so what we need to do is not change the word, but change how the word is understood. We must explain, carefully, again and again, that schizophrenia is an illness, with a course, symptoms and forms of treatment. We must explain that it is not associated with multiple personalities. We must explain that a certain path for recovery may lie ahead for many, if not most, people who have the illness. We must explain that no one is ‘at fault’ for having the illness, and all people with the illness still need love and support.

And perhaps then we will move towards a de-stigmatised world for all the people who have schizophrenia.

Dr Richard Schweizer lives with schizophrenia. You can read more about his journey here.